6. TEORÍAS SOBRE LA CINÉTICA DE CRISTALIZACIÓN
6.4. Teoría de la nucleación de Lauritzen-Hoffman
Lead organization Supreme Council of Health
SRO Assistant Secretary General of Policy Affairs
Project Manager Manager, Healthcare Facility Planning, Planning and Assessment
Background and Justification • Currently the majority of healthcare services in Qatar are provided within a hospital setting. Qatar is expected to continue to significantly increase hospital bed capacity in the next few years to meet rising demand for services. The expansion requires significant additional coordination to ensure Qatar develops the right services in the right locations. This is likely to become further complicated because of the private sector’s increasing involvement. Additionally, there will be a strong focus on developing community-based services, including planning for primary care and continuing care projects
• To address these problems, Qatar is developing an infrastructure master plan linked to the model of care that determines the size, scope and geographic distribution of facilities and large-scale technical equipment (e.g. equipment costing more than 10M QAR) required in Qatar
• The healthcare infrastructure master plan will be developed to:
• avoid the unnecessary duplication of services if those services are not aligned with patient volumes
• ensure infrastructure plans take into account key determinants, such as workforce
• allow for sound and efficient use of financial resources
• control for supply-induced demand due to misalignment of incentives
• This project is linked to the Capital Expenditure Committee, which will enforce the infrastructure master plan
Objectives • To ensure integrated and coordinated healthcare infrastructure based on population needs
Outcomes • Effective Project Management of the development of the Infrastructure Master Plan (from Work stream 1: Project Management)
• More effective Demand and Capacity planning for healthcare in Qatar (from Work stream 2: Demand and Service Planning)
• An estimation of the future healthcare facilities required for Qatar (from Work stream 3: Facilities Planning)
• A conceptual project brief for the future facilities requirements, including major equipment requirements (from Work stream 4: Facilities Analysis, Projections and Urban Planning)
• An estimate of the revenue and capital implications of delivering the overall Master Plan (from Work stream 5: Financial Considerations)
• A definition of the organizational capability, and the regulatory authority required of the SCH, to promulgate the QHFMP and manage the implementation of the QHFMP (from Work stream 6: Legal/Regulatory)
• A 20 year Strategic Plan and the 5 year Action Plan (from Work stream 7: Report writing)
• IT Solutions, including GIS applications and data, to support development and implementation of the Infrastructure Master Plan (from Work stream 8: IT Solutions) Outputs 6.4.1 A Qatar Health Facilities 20 year Strategic Master Plan
6.4.2 A Qatar Health Facilities 5 year Action Plan 6.4.3 Recommendation for regular updates of the plan
6.4.4 Design, development and handover of GIS system and applications Baseline and target to 2011-
Project Name 6.4 Healthcare Infrastructure Master Plan
Key Assumptions • The key assumption for this project is that interdependencies with other projects can be managed, particularly those defining and implementing desired models of care within Qatar, including:
1.1 Primary Care as the Foundation 1.2 Configuration of hospital services 1.3 Continuing care design
1.4 Mental health design
1.5 Emergency and urgent care services 1.6 Community pharmacies
2.5 Private sector involvement 4.1 Workforce planning Estimated completion 2013
Risk and Mitigation actions Risks Mitigation The interdependent NHS projects will
not be implemented and managed in a timely manner
Liaise closely with the NHS Programme Managers to track progress of
relevant projects Getting full endorsement and commitment
from stakeholders
Applying pressure from higher authorities in the SCH on stakeholders to ensure timely cooperation
Obtaining complete and accurate data in a timely manner in order to affect the analysis
Applying pressure from higher authorities in the SCH to ensure timely data collection Agreeing on assumptions in the demand
and capacity analysis Working closely with the SCH to ensure agreement from the beginning of the process
Agreeing preferred options for the Model
of Care and Operating Model Working closely with the SCH to ensure agreement from the beginning of the process
Validating the input data and assumptions used in the financial model
Working closely with the SCH to ensure agreement from the beginning of the process
Obtaining access to the national GIS system
Working closely with the MMUP to ensure access
Successfully completing the hand-over phase which will enable SCH staff to use and update the GIS system going forward
Working up to that point and ensuring that SCH staff are in the loop and aware of the process well in advance
Project Name 6.4 Healthcare Infrastructure Master Plan Key Stakeholders and cross-
sectoral linkages
• Regulatory Health Authority: • Supreme Council of Health
• Public Providers
• Hamad Medical Corporation • Primary Health Care Corporation
• Private Providers: • Sidra
• Al Ahli Hospital • Doha Clinic Hospital • American Hospital • Al Emadi Hospital • Al Hayat Polyclinic • Apollo Polyclinic • Aspetar • Naufar • Al Shafalah Centre
• Al Noor Institute for the Visually Impaired
• Ministries
• Ministry of Interior • Ministry of Labor
• Ministry of Municipality and Urban Planning
• Developers • Barwa
• Qatari Diar (Lusail, QFZ) • Musheireb
• Urban Development Corporation
• Other Authorities and Stakeholders
• General Secretariat for Development Planning • Qatar Red Crescent Society
• Qatar Statistics Authority • Qatar 2022 Supreme Committee • Qatar Tourism Authority
• GIS Authority • Qatar Rail • Qatar Petroleum
Inter-project Dependencies 1.1 Primary Care as the Foundation 1.2 Configuration of Hospital Services 1.3 Continuing Care Design
1.4 Mental Health Design
1.5 Emergency and Urgent Care Services 1.6 Community Pharmacies Strategy 2.5 Private Sector Involvement 4.1 Workforce Planning
Project Name 6.4 Healthcare Infrastructure Master Plan Governance
Executive
Committee HE the Minister
Assistant Secretary General SRO Director NHS Project 6.4 Project Team NHS Ministerial Program Board NHS Steering Group NHS Program Governance Project Governance
Quality Assurance • Project quality will be assured by:
• Project Board monitors overall project delivery and effectiveness of implementation
• Project performance is monitored on a monthly basis through team meetings and the NHS Program Steering Group
• An internal quality assurance process conducted by the core PMO team and the project lead, which entails review of all deliverables produced to ensure adherence to quality criteria, to ensure consistency and to avoid duplication Estimated Cost 10 - 20 million QAR
Project Plan
2012 2013 2014 2015 2016 2017 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N DNHS PROJECT
6.4 HEALTHCARE
INFRASTRUCTURE
MASTER PLAN
Workstream 1: Project Management Workstream 2: Demand and Service Planning Workstream 3: Facilities Planning Workstream 4:Facilities Analysis, Projections and Urban Planning
Workstream 5 Financial Considerations
Workstream 6: Legal/Regulatory
Workstream 7 Writing the 20 Year Strategy and the 5 Year action Plan 1 2 3 4 5 6 7 8
Project Name 6.5 Capital Expenditure Committee Establishment
Related NHS Goal: Effective and affordable services in accordance
with the principle of bearing the costs of healthcare.
Lead organization Supreme Council of Health
SRO Assistant Secretary General for Policy Affairs
Project Manager Manager, Healthcare Facility Planning, Health Planning and Assessment
Background and Justification • Infrastructure building activities are a major driver of annual healthcare costs in Qatar
• There has been a general lack of coordination and governance regarding infrastructure planning in Qatar. With the development of a master plan, a body will be needed to oversee stewardship of the plan and to: • facilitate consistent decision making
• foster integration among all key providers, including private providers • ensure that infrastructure spending is linked to needs and aligned to the
model of care
• The capital expenditure committee must be given legislative power to enforce its decisions
• Private providers requiring any public funding will need approval from the capital expenditure committee
Objectives • To ensure that infrastructure development is based on needs and aligned to the model of care
• To develop a Certificate of Need (CoN) process for significant capital expenditure projects with the Qatar health sector
• To provide a mechanism for the effective scrutiny of the CoN in accordance with the Qatar Infrastructure Master Plan and approved SCH policies and standards Outcomes • Creation of an effective and evidence based capital expenditure CoN
review mechanism
• Contribute to the efficient use of public expenditure for facilities and large-scale technical equipment projects
Outputs 6.5.1 Establishment of the capital expenditure committee according to the agreed terms of reference
6.5.2 Defining the certificate-of-need process for Qatar Baseline and target to 2011-
2016 (NDS) • The Supreme Council of Health to establish a Capital Expenditure Committee including the approval of terms of reference and membership by the end of 2013
• The Supreme Council of Health to establish mandated certificate of need process by end of 2013
• 100% of new eligible capital expenditure projects to be compliant with the certificate of need process by end of 2013
Key Assumptions • That the Healthcare Infrastructure Master Plan will be delivered as set out in project 6.4
• That the Capital Expenditure Committee will not meet until the Healthcare Infrastructure Master Plan has been approved
Estimated completion 2013
Risk and Mitigation actions Risks Mitigation That the development of the capital
expenditure committee and processes is not aligned with the Project 1.2 Configuration of Hospital Services or Project 6.5 Healthcare Infrastructure Master Plan
Close working between projects teams involved with each project
Lack of cooperation from other Ministries and key healthcare stakeholders
Utilize project governance with stepped escalation of the risk until stakeholder alignment is achieved
Project Name 6.5 Capital Expenditure Committee Establishment Key Stakeholders and cross-
sectoral linkages
• All providers of healthcare in Qatar – including all public and private providers and the entire spectrum of care from primary care to continuing care.
• Ministry of Municipality and Urban Planning
• Ministry of Economy and Finance
• Developers (including Barwa, Qatari Diar (Lusail, QFZ), Musheireb, Urban Development Corporation)
• Qatar 2022 Supreme Committee Inter-project Dependencies 1.1 Primary Care as the Foundation
1.2 Configuration of Hospital Services 1.3 Continuing Care Design
1.4 Mental Health Design
1.5 Emergency and Urgent Care Services 1.6 Community Pharmacies Strategy 2.5 Private Sector Involvement 4.1 Workforce Planning
6.4 Healthcare Infrastructure Master Plan
Governance The project manager is responsible for the delivery of the project and reports on progress through the NHS PMO on a monthly basis. The project manager also reports on a regular basis to the SRO
Executive
Committee HE the Minister
Assistant Secretary General SRO Director NHS Project 6.5 Project Manager NHS Ministerial Program Board NHS Steering Group NHS Program Governance Project Governance
Quality Assurance • Project quality will be assured by:
• project Board monitors overall project delivery and effectiveness of implementation
• project performance is monitored on a monthly basis through team meetings and the NHS Program Steering Group
Project Plan
2012 2013 2014 2015 2016 2017 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N DNHS PROJECT
6.5 CAPITAL
EXPENDITURE
COMMITTEE
ESTABLISHMENT
Define scope and terms of reference of capital expenditure committee Develop certificate-of- need process based on international best practices. Establish capital
expenditure committee On-going work of capital expenditure committee, including annual review of the infrastructure master plan
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